Komplementer terápiás gyógymódok megítélése a perioperatív ellátásban dolgozó egészségügyi szakdolgozók között

Absztrakt: Bevezetés: Magyarországon az egészségügyi szakdolgozók viszonyulása a komplementer terápiás gyógymódokhoz még nem vizsgált téma. Célkitűzés: Célunk volt felmérni a Semmelweis Egyetem hat, perioperatív ellátást végző klinikáján az egészségügyi szakdolgozók ismeretét és véleményét a természetgyógyászattal kapcsolatban. Módszer: Anonim, papíralapú kérdőíves felmérést végeztünk. 82%-os válaszadási arány mellett összesen 119 kérdőív adatait dolgoztuk fel leíró statisztikai elemzéssel és χ2-próbával. Eredmények: A válaszadók mindössze 25,2%-a tartotta eléggé tájékozottnak magát, 68,1%-uk érdeklődött és 60,5%-uk tanulna a természetgyógyászatról. A napi munka során 70,6%-uk szívesen alkalmazna komplementer terápiás gyógymódokat, szignifikánsan gyakrabban azok, akik saját betegség esetén is igénybe veszik e gyógymódokat (p = 0,0027). A legnépszerűbb gyógymódok a homeopátia, az alternatív masszázs- és mozgásterápia, az akupunktúra és a manuálterápia voltak. Következtetés: A nemzetközi szakirodalommal egyezően idehaza is a vizsgálatunkban felmért szakdolgozók nyitottak és érdeklődőek a természetgyógyászattal kapcsolatban. Orv. Hetil., 2017, 158(10), 368–375. | Abstract: Introduction: Perioperative healthcare professionals’ attitudes towards non-conventional treatments have not been explored in Hungary yet. Aim: Our goal was to survey healthcare professionals’ attitude and knowledge towards naturopathy in six clinics of the Semmelweis University that provide perioperative care. Method: An anonymous, paper-based questionnaire was used. With an 82% response rate, the data was gained from 119 questionnaires and was processed using statistical analysis and chi-squared test. Results: Only 25.2% of those surveyed considered themselves to be well-informed in this field. 68.1% of the participants had an interest in naturopathy and 60.5% would have liked to learn about naturopathy. 70.6% would be willing to use non-conventional treatments in their daily work, predominantly those who have used these methods in the case of their own illness, p = 0.0027. The most popular treatment methods included homeopathy, alternative massage and movement therapy, acupuncture and manual therapy. Conclusion: As anticipated based on international literature in this field, those Hungarian healthcare professionals who took part in our survey showed openness and interest towards naturopathy. Orv. Hetil., 2017, 158(10), 368–375

A Fragmenting Protocol with Explicit Hydration for Calculation of Binding Enthalpies of Target-Ligand Complexes at a Quantum Mechanical Level

Optimization of the enthalpy component of binding thermodynamics of drug candidates is a successful pathway of rational molecular design. However, the large size and missing hydration structure of target-ligand complexes often hinder such optimizations with quantum mechanical (QM) methods. At the same time, QM calculations are often necessitated for proper handling of electronic effects. To overcome the above problems, and help the QM design of new drugs, a protocol is introduced for atomic level determination of hydration structure and extraction of structures of target-ligand complex interfaces. The protocol is a combination of a previously published program MobyWat, an engine for assigning explicit water positions, and Fragmenter, a new tool for optimal fragmentation of protein targets. The protocol fostered a series of fast calculations of ligand binding enthalpies at the semi-empirical QM level. Ligands of diverse chemistry ranging from small aromatic compounds up to a large peptide helix of a molecular weight of 3000 targeting a leukemia protein were selected for systematic investigations. Comparison of various combinations of implicit and explicit water models demonstrated that the presence of accurately predicted explicit water molecules in the complex interface considerably improved the agreement with experimental results. A single scaling factor was derived for conversion of QM reaction heats into binding enthalpy values. The factor links molecular structure with binding thermodynamics via QM calculations. The new protocol and scaling factor will help automated optimization of binding enthalpy in future molecular design projects

Nem konvencionális gyógymódok használata sebészeti betegek között

Absztrakt Bevezetés: A nem konvencionális gyógymódok egyre emelkedő használata miatt tudnunk kell ezek igénybevételéről a perioperatív ellátás során is. Célkitűzés: A szerzők felmérték az elektív műtétre váró betegek viszonyulását a természetgyógyászati módszerekhez, valamint ezek esetleges igénybevételét és az ezt befolyásoló tényezőket. Módszer: Anonim, kérdőíves felmérést végeztek a Semmelweis Egyetem, I. Sebészeti Klinikán 2014. július és 2016. április között. Eredmények: Az 519 kitöltő (21%-os válaszadás) 63,6%-a érdeklődött a nem konvencionális gyógymódok iránt. Természetgyógyászati gyógymódot a válaszadók 26,8%-a vett már igénybe: e csoportban szignifikánsan több volt a nő (p = 0,022; OR: 1,066–2,3635), a diplomás (p = 0,000315; OR: 1,3915–3,1132), a 40–49 éves (p = 0,012419; OR: 1,1451–3,2405) és a hormonális betegségben szenvedő (p = 0,039482; OR: 1,0186–5,7242). Élettartam-prevalenciát tekintve a hagyományos kínai orvoslás (8,9%), az alternatív mozgás- és masszázsterápia (7,5%), illetve a homeopátia (7,3%) voltak a legnépszerűbb gyógymódok. Mindössze a betegek 12,9%-a számolt be e módszerek használatáról kezelőorvosának. Következtetés: A sebészeti betegek érdeklődőek a természetgyógyászattal kapcsolatban, és negyedük igénybe vesz ilyen gyógymódokat, akár a perioperatív időszakban is. Orv. Hetil., 2016, 157(37), 1483–1488. | Abstract Introduction: Due to the rise in use of non-conventional therapies, we may consider the application of those in perioperative setting. Aim: The aims of the authors were to measure the attitude of patients waiting for elective surgery towards naturopathic methods, to determine their use and factors influencing their usage. Method: A questionnaire was applied that patients filled in individually and anonymously at the First Department of Surgery of Semmelweis University, between July 1, 2014 and April 30, 2016. Results: 63.6% of the 519 participants (response rate = 21%) were interested in non-conventional therapies, and 26.8% of them applied naturopathy. In this group there were significantly more females (p = 0.022; OR: 1.066–2.3635), patients with university degree (p = 0.000315; OR: 1.3915–3.1132), aged 40–49 (p = 0.012419; OR: 1.1451–3.2405), and patients with hormonal disease (p = 0.039482; OR: 1.0186–5.7242). In terms of lifetime prevalence the most popular methods were traditional Chinese medicine (8.9%), alternative movement and massage therapy (7.5%) and homeopathy (7.3%). Only 12.9% of the patients reported the application of these methods to the physician. Conclusion: Surgical patients are interested in naturopathic methods, and one-fourth of them actually use them even in the perioperative period. Orv. Hetil., 2016, 157(37), 1483–1488

Herbal medicine use by surgery patients in Hungary: a descriptive study

BACKGROUND: The popularity of non-conventional treatments, especially the consumption of herbs is showing an increasing tendency all over the world. The consumption of herbal medicines might cause several complications during perioperative care. METHODS: The survey was conducted at the First Department of Surgery of Semmelweis University and focused on the demographics of patients consuming herbal medicines who had undergone elective surgery between July 1(st) 2014 and February 28(th) 2015. A one-page questionnaire, that the patients filled in individually and anonymously, was used. The response rate was 17.3 %. RESULTS: Out of the 390 patients who filled in the questionnaire, 7.2 % (28 patients) used herbal medicines, 3.6 % (14 patients) of them two weeks prior to their hospitalization. The other 3.6 % (14 patients) took herbal medicines sometime in the past. The majority of those who have ever consumed herbs are women (18/28), have completed secondary or tertiary education (23/28), more than half of them suffer from tumorous diseases and only a quarter of them (7/28) informed their physician about their use of herbal medication of their own accord. CONCLUSIONS: Attention must be paid to the exploration of herb consumption habits of surgery patients during the preoperative examinations in order to avoid potential side effects, complications or drug interactions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12906-015-0890-2) contains supplementary material, which is available to authorized users

Complementary and alternative medicine: attitudes, knowledge and use among surgeons and anaesthesiologists in Hungary

BACKGROUND: Despite their worldwide popularity the question of using non-conventional treatments is a source of controversy among medical professionals. Although these methods may have potential benefits it presents a problem when patients use non-conventional treatments in the perioperative period without informing their attending physician about it and this may cause adverse events and complications. To prevent this, physicians need to have a profound knowledge about non-conventional treatments. METHODS: An anonymous questionnaire was distributed among surgeons and anaesthesiologists working in Hungarian university clinics and in selected city or county hospitals. Questionnaires were distributed by post, online or in person. Altogether 258 questionnaires were received from 22 clinical and hospital departments. RESULTS: Anaesthesiologists and surgeons use reflexology, Traditional Chinese Medicine, herbal medicine and manual therapy most frequently in their clinical practice. Traditional Chinese Medicine was considered to be the most scientifically sound method, while homeopathy was perceived as the least well-grounded method. Neural therapy was the least well-known method among our subjects. Among the subjects of our survey only 3.1 % of perioperative care physicians had some qualifications in non-conventional medicine, 12.4 % considered themselves to be well-informed in this topic and 48.4 % would like to study some complementary method. Women were significantly more interested in alternative treatments than men, p = 0.001427; OR: 2.2765. Anaesthesiologists would be significantly more willing to learn non-conventional methods than surgeons. 86.4 % of the participants thought that non-conventional treatments should be evaluated from the point of view of evidence. Both surgeons and anaesthesiologists accept the application of integrative medicine and they also approve of the idea of teaching these methods at universities. CONCLUSIONS: According to perioperative care physicians, non-conventional methods should be evaluated based on evidence. They also expressed a willingness to learn about those treatments that meet the criteria of evidence and apply these in their clinical practice

Additional file 1: of Complementary and alternative medicine: attitudes, knowledge and use among surgeons and anaesthesiologists in Hungary

The English translation of the questionnaire. (DOCX 18 kb

Additional file 2: of Complementary and alternative medicine: attitudes, knowledge and use among surgeons and anaesthesiologists in Hungary

List of hospitals participated in the survey. (DOCX 19 kb

Systematic exploration of multiple drug binding sites

Background: Targets with multiple (prerequisite or allosteric) binding sites have an increasing importance in drug design. Experimental determination of atomic resolution structures of ligands weakly bound to multiple binding sites is often challenging. Blind docking has been widely used for fast mapping of the entire target surface for multiple binding sites. Reliability of blind docking is limited by approximations of hydration models, simplified handling of molecular flexibility, and imperfect search algorithms. Results: To overcome such limitations, the present study introduces Wrap 'n' Shake (WnS), an atomic resolution method that systematically "wraps" the entire target into a monolayer of ligand molecules. Functional binding sites are extracted by a rapid molecular dynamics shaker. WnS is tested on biologically important systems such as mitogenactivated protein, tyrosine-protein kinases, key players of cellular signaling, and farnesyl pyrophosphate synthase, a target of antitumor agents